AccountId: 011433970860
ContactId: 37bec77e-6d67-49a5-ae2d-04975dee7aa4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 197770 ms
Total Talk Time (AGENT): 100377 ms
Total Talk Time (CUSTOMER): 111424 ms
Interruptions: 6
Overall Sentiment: AGENT=2.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/37bec77e-6d67-49a5-ae2d-04975dee7aa4_20250124T19:22_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I'm calling from a medical office. I'm trying to get benefits on this patient's um policy.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you with benefits. What is your name? I'm sorry?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] [PII], thank you. And what is a good callback number?
[CUSTOMER][NEUTRAL] [PII] [PII] [PII].
[AGENT][NEUTRAL] And [PII], what is the policy number for the patient, please?
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII], and date of birth [PII].
[AGENT][POSITIVE] All right, thank you. My pleasure to help you with that eligibility and benefits for share, share, I can't even say your first name.
[CUSTOMER][NEUTRAL] [PII] um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah. There you go.
[AGENT][NEUTRAL] I am showing that her policy is active with the effective database [PII].
[AGENT][NEUTRAL] This is a secondary policy to the policyholders' major medical.
[CUSTOMER][NEUTRAL] You said you're [PII] from Center for Complex you the nurse case manager.
[AGENT][NEUTRAL] And what type of benefits are you needing, [PII]?
[CUSTOMER][NEUTRAL] Um, outpatient hospital.
[AGENT][NEUTRAL] All right. And she does have outpatient coverage. The maximum we can pay per calendar day is $300 towards her deductible, co-pay, or co-insurance.
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] OK, say that again, $300.
[AGENT][NEUTRAL] Per calendar day.
[CUSTOMER][NEUTRAL] Per calendar day OK.
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] And that is what we can pay toward the deductible, co-pay or co-insurance of her major medical.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][POSITIVE] No, you're welcome.
[AGENT][NEUTRAL] And that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, so place if there's uh for major medical you'll pay $300 per day per per day for that outpatient surgery.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] And that goes towards your deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Of her major medical.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Medical.
[CUSTOMER][NEUTRAL] OK, that's what I needed to know.
[AGENT][POSITIVE] Well, it has been a pleasure to assist you.
[CUSTOMER][POSITIVE] Um, thank you. Your name is.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK, is there a call reference number?
[AGENT][NEUTRAL] Call reference number is my name and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] And thank you for calling APL Emmy. You have a wonderful afternoon and a very happy weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.